Company Profile

Catholic Relief Services is the official international humanitarian agency of the Catholic community in the United States. CRS works to save, protect, and transform lives in need in more than 100 countries, without regard to race, religion or nationality. CRS’ relief and development work is accomplished through programs of emergency response, HIV, health, agriculture, education, microfinance and peacebuilding. CRS Ghana was established in 1958, a year after Ghana gained independence. In Ghana, CRS works with local partners to tackle poverty on several fronts including improving health and nutrition; increasing access to safe water and improved sanitation; promoting agriculture to enhance food security; and increasing financial assets through Savings and Internal Lending Communities. 

Job Description

Scope of Work Endline Study in Kumbungu District for Promoting Maternal and Infant Survival Excellence (PROMISE ) Project

Background
Catholic Relief Services prides itself with over 50 years of dedicated service to the Ghanaian people. Since 1958, CRS has been working with the support of the Government and in partnership with the local Catholic Church to improve the quality of life among the poorest and most vulnerable populations. The scope of CRS Ghana’s development assistance has varied over time with program activities in Education, Health, Agriculture, HIV and AIDS, Conflict Resolution, Microfinance and Water and Sanitation. CRS has reached millions of Ghanaians, particularly women and children with development assistance over the agency’s history in Ghana.

Since 2011, CRS has been working in close collaboration with Ghana Health Service to address high rates of maternal and infant mortality. Through the USAID-funded Encouraging Positive Practices for Improving Child Survival (EPPICS) Project implemented in East Mamprusi District from 2011-2015, Ghana Health Services and CRS combined health facility and community based strategies to create demand for qualified health care. The impact of this initiative included a 109% reduction in institutional maternal mortality, 131% reduction in institutional infant mortality and 80% reduction in neonatal mortality in the district. With these promising results from the EPPICS intervention, Catholic Relief Services (CRS) and Ghana Health Services scaled up these successful strategies in the Kumbungu District through the Promoting Maternal and Infant Survival Excellence (PROMISE) initiative, funded through CRS’ discretionary resources. These interventions have been rolled out since 2016 in some selected communities within the district.  

CRS Ghana therefore seeks to retain the servces of consultant to lead the conduct of an endline study for the PROMISE Project. The details of the Scope of Work as provided below describes the role and responsibilities of the consultant being sort to lead the endline study

Project Description
In Ghana, maternal and child mortality rates are unacceptably high, despite concerted efforts from Ghana Health Services and its Development Partners (USAID, UNICEF and WHO, among others). In fact, all of Ghana’s health-related Millennium Development Goal targets were not met, though significant progress was made in reducing institutional maternal mortality and under 5 mortality  . Maternal and child health indicators are the worst in the Northern region of Ghana, and  the Kumbungu district is one of the lowest performing of the 26 districts in the region.

The Kumbungu district has an estimated population of 86,000 inhabitants . Key challenges to improving maternal and newborn health in the northern region in general and Kumbungu district in particular, include low level of knowledge on appropriate maternal and child health care practices.  Over the years, the district has suffered  high maternal and neonatal mortality rates due to post-partum haemorrhage and inappropriate care for neonates, limited access to health facilities and low quality of health services.  These challenges result in low utilization of healthcare care facilities for maternal and child health services.  Ghana’s National Health Sector Strategy (2012 – 2017) supports these findings, highlighting low levels of MCH related knowledge and practices, inability for community members to reach points of care and poor quality of care as the key reasons for low utilization of maternal and newborn services. A recent study in rural communities in northern Ghana revealed that if a woman or caregiver has improved MCH related knowledge and enjoyed a positive experience at a healthcare facility before, during, and after childbirth, she will be more likely to return to the facility for postpartum care for herself and postnatal care for her baby .

The PROMISE Project seeks to address three challenges: (1) low knowledge of appropriate healthcare practices, (2) limited georgraphic access to healthcare facilities and  (3) low capacity of healthcare providers to provide quality services.

Objective and Scope of the Evaluation
The main objective of this endline evaluation is to conduct a comprehensive, participatory final evaluation with consideration of the theory of change, implementation, management, lessons learned and sustainability. The endline evaluation is to is to establish a current community and facility level end line evaluation status on knowledge, access, utilization and provision of MNCH services in the Kumbugu district in relation to the regional and national situation. The findings will be consolidated to establish a comprehensive understanding on MNCH in the target areas. The end line evaluation findings will be used to assess changes within each project area, as per indicators set out in the original results frame. The final evaluation will build on the baseline studies to enhance learning and understanding of the project results as follows: assess relevance, effectiveness, efficiency, impact and sustainability of activities and measure outcomes. It will identify lessons learned draw conclusion and provide recommendations for future maternal and child health interventions.
The specific objectives of the endline survey will be to:

• Relevance:
  • To what extent the objectives of PROMISE intervention were consistent with beneficiaries’ expectations, the country's needs, global priorities and government partners?
  • To what extent were the objectives of the program valid?
  • Are the activities and outputs of the program consistent with the overall goal and the attainment of its objectives?
  • Are the activities and outputs of the program consistent with the intended impacts and effects?
• Effectiveness:
  • To what extent were the objectives of PROMISE achieved?
  • What were the major factors influencing the achievement or non-achievement of the objectives?
  • How effective is the program at reaching men (husbands and fathers-in-law)?
  • Are planned strategies appropriate to address the MNCH problems identified in the target areas? Do the framework, assumptions and design match the local MNCH conditions.
  • To what extent is the monitoring system operational?  How manageable, reliable, valid, and useful is data generated by the system?
  • What is the extent of replicability of the best practices/lessons learnt in the PROMISE project? What strategies will be effective in achieving the replication?
• Efficiency:
  • To what extent resources (funds, expertise, time, etc.) were converted to results economically and quality?
• Impacts:
  1. To what extent has the expected change in the strategic objectives (see Annex 1) been achieved compared to the baseline levels?
  2. To what extent have internal factors (interventions, structures and systems) positively influenced achievement of program impact?
  3. To what extent have external factors affected the achievement of project impact?
  4. Are there any negative impacts or unintended consequences of the program that need to be addressed, and how?
  5. To what extent have the partnership with project partners and community field agents (joint partner field monitoring events, community reflection meetings, partner reflection meetings etc.) affected the achievement of program impact?
  6. As defined and measured, do the performance indicators provide useful and reliable data on program progress and impacts?
• Sustainability:

1. Are the gains (if any) of the project in terms of improvements in MNCH sustainable in the long term?
2. What were the major factors which influenced the achievement or non-achievement of sustainability of the project?
3. What is the level of ownership acquired by the stakeholders? What is the extent to which  PROMISE collaborates  with the GHS? Are beneficiaries able to receive follow-up technical support from their respective District Health Directorates?
4. How can they evolve andor continue the benefits resulting from the action after the end of the intervention?
5. Are improvements (if any) in access to health care, improvement in the quality of health care delivery) sustainable?
6. What activities are sustainable by communities without PROMISE support and why? What activities do not appear to be sustainable and why?

Methodology of the Final Evaluation
The final evaluation will use both quantitative and qualitative methods. Quantitative methods will be used for the collection, analysis and reporting on the impact and outcome indicators by sector and qualitative methods will be used to determine the effectiveness, stakeholder perceptions, and lessons learned. The final evaluation will largely follow the methodology used in the baseline ensure valid comparability from beginning to project end. The survey will consider; district and community-level institutional capacity in participating in project implementation; coverage, knowledge, attitudes and practices on MNCH.  Further discussion on the details of the sampling strategy will be possible with the consultant.  The consultant will work closely with CRS field staff to ensure this is achieved.

Evaluation team, management, role and coordination

• Evaluation Team: The evaluation team shall consist of the consultant, the Health Program Manager, PROMISE Coordinator, Community Mobilization Specialist and MEAL Specialist.  
• Management: CRS will work with external consultants and/or a consulting firm to conduct the final evaluation, while CRS will coordinate the overall MEAL processes and data systems. The external consultant or firm will be selected through an open solicitation. Applications will be reviewed against a set of criteria including experience working in Northern Ghana, relevant regional knowledge, analytical capacity, local language proficiency and experience in conducting process and impact evaluations for MNCH, qualitative and quantitative data analysis, etc.
• Role of CRS Ghana and collaborators: CRS Ghana will perform the following roles in the conduct of the End line study:
  • Provide project documents such as the project proposal, list of communities and health facilities
  • Form an end line Assessment Coordinating Team
  • Review Evaluation plan and tools
  • Facilitate the conduct of community entry processes in all the survey communities
  • Provide technical review and share feedback on draft report
  • Support with logistics and organization of stakeholder review meeting after the evaluation
• Main Tasks of the Consultancy:

The consultant(s) will work in conjunction with the Catholic Relief Services’ to finalize the design and plan for the study. Within project districts, the consultant will work with the Project’s Community Mobilization Specialist, and partners to co-ordinate, conduct the study.  The consultant is expected to undertake the following tasks:

1. Carry out a desk-review of relevant project documents (to be provided upon signing the contract), including project proposal, results framework/output and outcomes table, budget and other relevant documents, a range of which will be agreed upon and made available prior to the conduct of the study
2. Email/telephone communications with PROMISE PM and M&E lead for detailed briefing
3. Develop an inception report, detailing the evaluation design, methodology, indicators, tools, work plan schedule and budget to carry out the assignment in the project districts. This will be developed and finalized in consultation with the PROMISE team in Catholic Relief Services.
4. Finalize a Sampling Design and Data Collection & Management Protocol that is standardized including key rapid catch indicators. The data collection tools should adequately address the gender (men and women) perspectives around MNCH
5. Facilitate training of field staff (supervisors, interviewers, observers/record reviewers) and pre-testing of data collection tools.
6. Finalize work plan and lead field data collection, data entry into a suitable platform, data cleaning, data analysis, and interpret and synthesize survey findings
7. Develop and submit the first draft of the end line evaluation study report and debriefing to Catholic Relief Services and Ghana Health Services. The reports should be comprehensive and provide detailed specific findings within the project area, providing key recommendations for implementation.
8. The lead consultant will be required to facilitate participatory reflection at a sitting with key project staff and partners and others to discuss the findings, identify learning and recommendations and develop an after-action plan based on the result of the end line evaluation
9. Submit the final evaluation report to CRS and this should comprise six (6) Hard Copies and an electronic copy. The raw data, the data-base which has been cleaned (both qualitative and quantitative, including original field notes for in-depth interviews and focus group discussions, as well as recorded audio material), and data collection tools used in the evaluation should be submitted together with the report. A simple inventory of material handed over will be part of the record. CRS has sole ownership of all final data and any findings shall only be shared or reproduced with the permission of CRS. The lead consultant will be expected to compile and submit the draft report, make a presentation to CRS, incorporate comments from presentation and submit a final report within 14 days of the end of the evaluation.
10. The consultant will be responsible for guiding the entire evaluation process and all other specific responsibilities as stipulated in the Terms of Reference and Evaluation Plan.

• Expected Profile of the Consultancy: The firm should provide:
  • A proof of a valid certificate of Incorporation and Commencement
  • CVs of key personnel who will be involved  in the assignment, evidence of similar assignment undertaken in the in the last 3 years (2013-2016)
  • Any other relevant information that will be useful to determining the suitability of the organizations for the assignment.

Reporting and dissemination plan (report structure and dissemination plan)

• Reporting:

Please note that the contents of the report will be analyzed and final payment will only be made upon approval of the evaluation and comparative analysis Report by CRS.
The final report is expected to be organized as follows:

• Executive Summary
• Introduction
• Study Description
• Methodology
• Summary of key findings including key indicators and other prioritized indicators with numerators, denominators and confidence limits
• Lessons Learned, Conclusions and Recommendations for future directions
• Annexes:
  • Data set
  • The Study Team Members
  • List of Interviewers
  • Methodology
  • Questionnaire, Guides/ tools
  • Evaluation plan
  • Terms of Reference

Please note that the contents of the report will be analyzed and final payment will only be made upon approval of the final evaluation and comparative analysis report by CRS.

• Final evaluation dissemination plan: After the evaluation, stakeholders including implementing partners and GHS representatives, local authorities, and other organizations implementing similar interventions will be invited to a workshop to validate evaluation findings and recommendations. CRS will share the final report with  the donor and prepare a summary report highlighting findings, lessons learned and recommendations to disseminate among relevant stakeholders, including the GHS, local government officials and other actors working in the  health sector in Ghana

Evaluation Key Audience
The final evaluation’s primary anticipated audiences are:

• CRS HQ: overall report on program performance to date
• National government actors: overall report on program performance and share program findings on MNCH with any initial recommendations
• Program implementation team: overall report on program performance
• Targeted communities: feedback on program performance

Budget
A proposed budget in GHS shall be included with Consultant’s submission (Consultancy fee, training and field testing and quantitative and qualitative data collection), and the final budget approved shall be fixed and not subject to negotiation

Deliverables

Time-frame and Payment scheme
The assignment is expected to commence starting 9th October 2017 and is expected to take a maximum of 30 days, which includes desk-review, preparation, and implementation, report-writing.

The consultant(s) will be paid an initial  20% at signing of contract with CRS, 40% after draft report is received and the final 40% when a satisfactory final report is received.

Required Skills or Experience

Expected Profile of the Consultant
The lead consultant and his/her team are expected to hold the following qualifications to be eligible for this call:

• A recognized university degree in Public Health,  medicine, international development, medical anthropology or related social science (at a minimum of masters’ level but preferably at doctorate level)
• Deep understanding of the health system in Ghana, organization of the health sector, the health sector value chain and the drivers of change in the health sector value chain.
• Demonstrated knowledge and experience working in the field of maternal, newborn and child health.
• At least 7 years experience in the area of public health and Child Survival issues both in organizations and in projects, field experience in Northern Ghana is preferred.
• Experience in the formulation, monitoring and evaluation of projects in maternal, newborn and child health/public health
• Should be highly familiar with evaluation design methodologies, performance measurement, quantitative and qualitative data collection and analysis
• A demonstrated high level of professionalism and an ability to work independently and in high pressure situations under tight deadlines